Two of the patients are symptom free and carrying out extremely active lives (cycling, hiking) without any restriction.

Patient number 3 with the 14 cm lesion no longer needs narcotic pain medication and is now able to work part-time.

Author's Conclusions

Protons can deliver high radiation doses to pelvic sarcomas with little morbidity and might offer an alternative if radical surgery is declined.

The author is interested in collaborative studies given the scarcity of these tumors.

Tumor types to be included in these studies should include chondrosarcoma, osteosarcoma, MFH of bone, and Ewing 's sarcoma.

Clinical/Scientific Implications

Although this study is limited in the number of patients evaluated and in the length of follow up, proton radiation seems to offer excellent disease control of pelvic tumors with minimal long-term toxicity.

It also appears that the use of proton radiation after biopsy and curettage may offer a less morbid treatment than the use of definitive surgery, allowing patients to maintain active and productive lifestyles.